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Background: Prescription drug misuse and its related risks are considered a worldwide public health issue. Current trends show that the extent of such phenomenon may not be limited to subjects with psychiatric disorders, as it also spreads to dance party and nightclub attendees, who often consume prescription drugs in combination with alcohol and psychoactive substances. This study aims to report the sociodemographic data and the psychiatric and clinical features of a sample of clubbers reporting prescription drugs use. Methods: Patients admitted to the psychiatry ward of the Can Misses Hospital in Ibiza were recruited for the study during a span of four consecutive years — The inclusion criteria were age 18—75 years old and the intake of psychoactive substances or more than five alcohol units during the previous 24 h. Substance use habits, psychopathological features, and use of unprescribed pharmaceuticals were investigated. Results: A total of subjects with psychoactive substance intoxication were recruited for the study. Conclusions: The use of prescription drugs is also common among clubbers, usually characterized by low propensity to be prescribed benzodiazepines, antipsychotics, or antidepressants. Prescription drugs may be an alternative to classic and novel psychoactive compounds or may be used to tamper and self-medicate the effects determined by the use of substances. Party goers should be adequately informed about possible risks of co-intake of psychoactive substances and prescription drugs to prevent serious medical and psychiatric consequences. Prescription drug misuse and related risks, including co-ingestion with recreational drugs, have recently risen as a worldwide public health phenomenon. They may involve a variety of medical and social consequences that require effective public health policies to counteract such habit, as well as continuous updates for health professionals to promote education and harm reduction 1 , 2. Prescription medicine misuse or non-medical use is commonly defined as the use of medications without a prescription or in a manner other than prescribed 3. This includes a number of conditions, such as using these compounds for purposes other than the medical condition they were prescribed for i. In , 14 countries in EU reported on the non-medical use of such compounds 5. Current trends show that the extent of prescription drug misuse is not limited to subjects with psychiatric disorders or co-occurring substance use disorders SUDs. In this context, the phenomenon of co-ingesting prescription drugs in order to imitate, potentiate, modulate, or counteract the effects of prohibited psychoactive substances has been increasingly reported 8. This trend involves not only novel highly potent opioid, such as fentanyl and its derivatives, or designer benzodiazepines but also antipsychotics, antidepressants, stimulants, performance-enhancing drugs PEDs , hormones, vitamins, beta-blockers, gabapentinoids and over-the-counter OTC drugs 8. For example, students and workers may consume attention deficit hyperactivity disorder ADHD medications such as methylphenidate to improve their academic performance or working tasks 1. Furthermore, compounds such as benzodiazepines e. With regard to the nightlife and clubbing scene, the situation shows peculiar characteristics. The growing offer of novel and traditional prescription drugs has found a fertile ground in this scenario. Summer holiday periods in popular resorts have historically represented an opportunity for excesses and experimentation, especially among young people who find an environment in which hedonistic partying is socially accepted and drugs are typically easily available Alcohol use, particularly during binge drinking, and psychoactive substance use are commonly reported among festival-goers and clubbers in holiday resorts; practices such as poly-substance abuse and prescription drug misuse have also been reported 13 — The use of a variety of pharmaceuticals including benzodiazepines 17 , 18 , stimulants 19 , 20 , opioids 21 , antidepressants 8 , and sedatives such as GHB 22 has been associated to dance music party attendees. Such heterogeneous cohort of compounds, presented in different forms and with various ways of intake e. Nevertheless, pharmaceuticals are often perceived as less harmful and less stigmatizing than illicit drugs, particularly among young people, partly due to these substances' legitimate medical purposes 23 , Moreover, information on the actions of these drugs is widely available in package inserts, advertisements, and on the internet; therefore, their effects including adverse reactions and dosages are considered more predictable Such phenomenon is further complicated by the rise on the nightlife market of novel psychoactive substances NPS. A number of these substances were originally developed as research chemicals and diverted for recreational purposes, as they often mimic the pharmacological effect of traditional drugs of abuse or popular prescription drugs 4. Their effects and related risks are often unknown to both users and health professionals, due to the scarcity of evidence-based information regarding their toxicological profiles and to the ever-changing nature of this market 7 , 26 — Nevertheless, growing evidence reported potential acute and chronic psychiatric risks associated to NPS consumption, including confusion; paranoid thoughts; auditory and visual hallucinations; dissociation; delusions of reference, persecution, grandeur, and jealousy; cognitive impairment; hypomanic states; aggressiveness and irritability; violence; and suicidal thoughts 8 , 29 — The current dynamic of recreational substance use is a serious matter of concern for public health institutions worldwide. In particular, the threats posed by psychoactive compounds and concomitant prescription drug misuse require updated policies provided by local and supranational regulatory agencies, as well as appropriate approaches by health professional, to prevent negative outcomes and reduce associated harms 32 , including deaths In such context, Ibiza and the Balearic Islands, two of the most popular destinations with nightlife resorts for summer holidays in Europe, may be considered as an interesting real-life scenario to explore such phenomenon. Previous studies confirmed a higher prevalence of risky behaviors for both residents and tourists in Ibiza, including problematic alcohol use, substance use, and sexual disinhibition 34 — Moreover, it has been reported that traffickers and dealers have introduced NPS and pharmaceuticals into the Ibiza drug market to test new compounds and drug combinations on unaware customers This study aimed to assess patients admitted to the psychiatric ward of the Can Misses Hospital in Ibiza for psychoactive substance intoxication, in order to 1 identify which psychotropic prescription drugs are mostly involved in cases of concomitant psychoactive substance use and 2 report the psychopathological features and patterns of consumption associated to prescription drug use in a nightlife resort setting. Patients admitted to the psychiatry ward of the Can Misses Hospital in Ibiza during summer when nightclubs are open May—October were recruited for the study during a span of four consecutive years — The subjects were evaluated according to the DSM-5 diagnostic classification. The inclusion criteria were age 18—75 years old and the intake of psychoactive substances or more than five alcohol units i. Clinical conditions such as delirium tremens , epilepsy, liver encephalopathy, dementia, and other neurological diseases, severe cardiac failure, diabetes mellitus, severe liver impairment, kidney failure, or neoplastic diseases were among the exclusion criteria, as the presence of such conditions could present a confounding factor. Demographic age, gender, family, and nationality and socioeconomic data living status, job status, and level of education were collected, as well as recent and past medical and psychiatric history, current pharmacological treatment, and alcohol and substance use habits including NPS , with a specific focus on prescription drugs misuse. Among these, recent and lifetime use of benzodiazepines e. TLFB was used to identify the main substance of abuse for each patient. The subjects were divided in three macro-groups according to the TLFB and the results of the urinalysis: psychostimulants e. This classification was derived from our previous reports on the topic 7 , Data collection was carried out in an anonymous and confidential way; all participants received a detailed explanation of the design of the study and a written informed consent was systematically obtained from every subject, according to the Declaration of Helsinki. Majorcan local ethics committee also gave approval to the study. The urine samples were extracted with a solid-phase cartridge Oasis MCX , and the obtained solution was evaporated until dry and reconstituted with mobile phase. The method was validated according to WADA guidelines and for a screening method in antidoping test defining selectivity, limit of detection LOD , recovery, carry over, and repeatability Independent samples t -test was used to determine whether or not there was a significant difference in scale scores between subjects who abused and subjects who did not abuse prescription drugs. One-way analysis of variance ANOVA followed by Tukey's post-hoc test was used to assess whether or not there was a significant difference in scale scores among subjects who abused different classes of prescription drugs. The median age of the patients was Nine patients were full-time or part-time students 8. All the subjects of the sample were diagnosed with substance intoxication at admission. These results will be described in a separate manuscript The most commonly reported compounds were benzodiazepines, which were used by 32 subjects. Table 1 presents the complete information on the type of pharmaceuticals reported by users. Table 1. The most common substances used by patients who declared prescription drug misuse. Prescription drug misuse was reported for 8 psychodepressor e. The percentage for each group of substance users is reported in Figure 1. Figure 1. According to their lifetime use of specific compounds, prescription drug consumption without medical supervision was reported by 31 stimulant users, 21 cannabinoid users, 10 depressor users, 7 opioid users, 7 empathogen—entactogen users, 5 dissociative users, and 1 psychedelic user. Figure 2. Figure 3. Figure 4. Therefore, our results show that such use is not only limited to subjects with psychiatric disorders and co-occurring SUD but can also involve subjects who are usually not considered as typical psychoactive substance users. This data pave the way for serious considerations on the possible pharmacological interactions with alcohol and other substances, as well as on other short- and long-term consequences, both physical and psychiatric. As users may concomitantly consume various prescription drugs and substances of abuse, an increased risk of drug—drug interactions may be observed, both pharmacokinetic e. This involves not only depressors, such as benzodiazepines, opioids, and alcohol, but also stimulant drugs commonly used by clubbers. For example, metabolic pathways of synthetic cathinones, antidepressants, and ADHD medications have been shown to overlap, including metabolism via cytochrome P enzymes and their inhibition Benzodiazepines were the most prevalent class of prescription drugs reported in our sample. This confirms the data from Messina et al. In terms of preventive strategies, the use of benzodiazepines in the context of a multiple substance use could be dangerous as it causes respiratory depression and risk of overdoses, specifically in combination with opiates, alcohol, ketamine and derivatives, and inhalants 18 , 43 , Specific policies and harm-reduction approaches should be advised for these potentially lethal combinations, particularly with the intake of large amounts of long half-life compounds, such as diazepam. Furthermore, a number of novel designer benzodiazepines, with undisclosed toxicological profiles and variable potencies, have recently been made available in the drug market. They are developed in order to mimic prescription benzodiazepines and Z-drugs, but they may lead users to adverse events of various severities, particularly if used in combination with other substances 4 , 45 , Among the different categories of substances, psychodepressors were the most commonly associated with the use of prescription drugs, whereas only a small percentage of psychodysleptic users reported such habit. The typology of subject using psychodysleptics such as LSD, psilocybin, MDMA, ayahuasca, and other plants, is characterized by the search for a strong inner experience, spirituality, and high level of emotionality 47 , The use of benzodiazepines and antipsychotics can inhibit or temper the perception of these experiences and therefore may not be chosen by users. With regard to antidepressants, which can determine affective blunting and enhance the distance from emotional experiences, the same consideration can be reported. This finding emphasizes how those patients are the most vulnerable in terms of psychopathological load. In this regard, those who report taking prescription drugs may actually be the subjects with a psychiatric history. A prescription drug may have already been tested for therapeutic purposes and therefore may have made the patient more accustomed to its use out of indication. Moreover, the high level of depression is an issue that needs to be considered and can represent a significant suicidal risk factor in people who misuse alcohol and psychoactive substances. In fact, the use of psychotropics can represent an additional risk factor, given the possibility of a consistent increase in the levels of impulsivity, violence, and self-directed aggression due to such drugs. Therefore, it is very relevant to evaluate these patients and to put specific strategies in place to manage these psychopathological manifestations, with a specific focus on the prevention of anti-conservative behaviors. A further point of interest, although expected, is the presence of high levels of depressive symptoms on the Hamilton scale in relation to the use of antidepressants without a specific medical prescription. For this reason, a shared strategy could be justified, even more than in other types of patients with dual disorders. Conversely, methylphenidate use was associated with lower scores at the Hamilton depression scale. This prescription drug with stimulant properties 49 , 50 , usually indicated for attention deficit hyperactivity disorder, can probably be chosen by users of psychostimulants as a cheaper alternative to cocaine and amphetamine. In the short run, it could also show some antidepressant properties, thus explaining the data observed at the HAM-D. The detection of methylphenidate among the prescription drugs reported in our sample may indicate some level of comorbidity between adult ADHD and SUD, as recently reported In terms of the role of the discharge psychiatric diagnosis, alcohol or substance use disorder showed a high prevalence, although the diagnoses of schizophrenia and bipolar spectrum disorder were also significantly reported. In some cases, the presence of a psychiatric comorbidity could justify the use of prescription drugs such as antidepressants, mood stabilizers, and benzodiazepines. Limitations of this study are represented by a low and heterogeneous sample size, with a high prevalence of benzodiazepine as the main prescription drug. Moreover, although the target of the study is that of young clubbers, a significant subgroup of participants were middle-aged adults. In conclusion, in this study, we have highlighted how the use of prescription drugs is common also among clubbers and disco-goers. These subjects usually do not have a previous psychiatric history and share a low propensity to be prescribed with benzodiazepines, antipsychotics, and antidepressants by a mental health professional. These data confirm that prescription drugs may be an alternative for classic and novel psychoactive compounds, may be used to modulate and temper the experience, and, in some cases, may be used to reduce the negative effects determined by the use of substances. From the treatment prospective and as a useful preventive strategy, a specific psycho-education process should be indicated for subjects at risk. Party-goers should be adequately informed about the possible risks of co-intake of NPS, classical substances, and prescription drugs to prevent serious medical and psychiatric consequences. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. MdG and AN wrote the manuscript. SS and LT performed the statistical analysis. AB and DD performed literature search about the topic and elaborated all the ethical procedures required for the study approval in both countries. GM coordinated all the study processes. All authors contributed to the article and approved the submitted version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Nonmedical use of prescription medications among adolescents in the United States: a systematic review. J Adolesc Health. Changes in the prevalence of non-medical prescription drug use and drug use disorders in the United States: — and — Drug Alcohol Depend. Misuse of prescription drugs. Google Scholar. Bersani FS, Imperatori C. Misuse, recreational use and addiction in relation to prescription medicines. New York, NY: Routledge PubMed Abstract. United Nations Office for Drug and Crime. World Drug Report United Nations CrossRef Full Text. Novel and traditional club substances are associated to psychopathological and medical sequelae: the Ibiza project. Abuse of prescription drugs in the context of novel psychoactive substances NPS : a systematic review. Brain Sci. Sexualised drug use in the United Kingdom UK : a review of the literature. Int J Drug Policy. Modeling motivations for non-medical use of prescription drugs. Addict Behav. Quetiapine abuse fourteen years later: where are we now? A systematic review. Subst Use Misuse. Work hard, party harder: drug use and sexual behaviour in young British casual workers in Ibiza, Spain. Binge drinking and prescription opioid misuse in the U. Am J Prev Med. Heavy drinking and non-medical use of prescription drugs among university students: a 9-year follow-up. Double dropping down under: correlates of simultaneous consumption of two ecstasy pills in a sample of Australian outdoor music festival attendees. Drug Alcohol Rev. Hum Psychopharmacol. Prescription drug abuse among ecstasy users in Miami. J Addict Dis. Benzodiazepine dependence among young adult participants in the club scene who use drugs. J Psychoact Drugs. Butler R, Sheridan J. Innocent parties or devious drug users: the views of primary healthcare practitioners with respect to those who misuse prescription drugs. Harm Reduct J. To Study, to party, or both? Assessing risk factors for non-prescribed stimulant use among middle and high school students. Palamar JJ. Am J Addict. Brennan R, van Hout MC. Gamma-hydroxybutyrate GHB : a scoping review of pharmacology, toxicology, motives for use, and user groups. J Psychoactive Drugs. Prescription drug abuse: insight into the epidemic. Clin Pharmacol Ther. Kelly BC, Vuolo M. Social network ties to nightlife and healthcare professionals and prescription drug misuse among young adults. The non-medical use of prescription drugs, policy direction issues. United Nations Office on Drugs and Crime, Importance of cyberspace for the assessment of the drug abuse market: preliminary results from the Psychonaut project. Cyberpsychol Behav. Promoting innovation and excellence to face the rapid diffusion of novel Psychoactive substances in the EU: the outcomes of the reDNet project. Novel psychoactive substances as a novel challenge for health professionals: results from an Italian survey. Hum Psychopharm Clin Exp. Mephedrone, compared with MDMA ecstasy and amphetamine, rapidly increases both dopamine and 5-HT levels in nucleus accumbens of awake rats. Br J Pharmacol. Non-medical use of novel synthetic opioids: a new challenge to public health. Substance related exogenous psychosis: a post-modern syndrome. CNS Spectr. A matter of life and death: substance-caused and substance-related fatalities in Ibiza in Hum Psychopharmacol Clin Exp. How deaths can help clinicians and policy-makers understand the risks of novel psychoactive substances. Br J Clin Pharmacol. Ibiza uncovered: changes in substance use and sexual behaviour amongst young people visiting an international night-life resort. Healthy nightclubs and recreational substance use. From a harm minimisation to a healthy settings approach. Substance-related psychopathology and aggressiveness in a nightlife holiday resort: Results from a pilot study in a psychiatric inpatient unit in Ibiza. Forensic Toxicol. Urinary excretion profile of methiopropamine in mice following intraperitoneal administration: a liquid chromatography-tandem mass spectrometry investigation. Drug Test Anal. Clinica Chimica Acta. Toxicological screening in the Amsterdam acute setting becomes more relevant if the standard panel of the drug-of-abuse point-of-care test is expanded with GHB ketamine. Toxicol Rep. Drug interactions with new synthetic opioids. Front Pharmacol. Synthetic cathinones and their potential interactions with prescription drugs. Ther Drug Monit. A longitudinal study of multiple drug use and overdose among young people who inject drugs. Am J Public Health. Acute poisoning from substance abuse of benzodiazepines. Akutt forgiftning ved rusrelatert bruk av benzodiazepiner. Tidsskr Nor Laegeforen. Curr Neuropharmacol. French Addictovigilance Network. Use of new psychoactive substances to mimic prescription drugs: The trend in France. Perfor Enhanc Health. Psychedelic fauna for psychonaut hunters: a mini-review. Front Psychiatry. Illicit methylphenidate use in an undergraduate student sample: prevalence and risk factors. Subst Abuse Treat Prev Policy. Eur Addict Res. Keywords: prescription drugs, novel psychoactive substance NPS , club drugs, psychopathology, substance usage disorders SUDs. Psychiatry The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Top bar navigation. About us About us. Sections Sections. About journal About journal. Article types Author guidelines Editor guidelines Publishing fees Submission checklist Contact editorial office. Psychiatry , 15 December Background Prescription drug misuse and related risks, including co-ingestion with recreational drugs, have recently risen as a worldwide public health phenomenon. Materials and Methods Patients admitted to the psychiatry ward of the Can Misses Hospital in Ibiza during summer when nightclubs are open May—October were recruited for the study during a span of four consecutive years —

Self-reported Xylazine Experiences: A Mixed Methods Study of Reddit Subscribers

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Official websites use. Share sensitive information only on official, secure websites. Corresponding author: Anthony Spadaro, Anthony. Spadaro pennmedicine. Xylazine is an alpha-2 agonist increasingly prevalent in the illicit drug supply. Specifically, we sought to answer the following: 1 what are the demographics of Reddit subscribers reporting exposure to xylazine? Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March to October People on Reddit described xylazine as an unwanted adulterant in their opioid supply. Among respondents on these Reddit forums, xylazine appears to be an unwanted adulterant. PWUDs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This appeared to be more common in the Northeast. Xylazine was investigated for potential use in humans, but rejected due to severe central nervous system and blood pressure adverse effects 2 - 4. The chemical structure of xylazine resembles phenothiazines, tricyclic antidepressants, and clonidine. Emerging evidence from forensic, confiscated, and donated drug samples demonstrate that xylazine is increasingly found in the opioid drug supply in the Northeast and rapidly spreading to the rest of the country. Reddit is one of the most popular and fastest-growing social networks currently, with over million monthly active subscribers. Specifically, we sought to answer the following: 1 what are the demographics of Reddit subscribers self-reporting exposure to xylazine? Study methods include natural language processing NLP to identify posts on Reddit related to xylazine use for qualitative analysis as well as posting a survey to Reddit to elicit the experiences of PWUD for quantitative analysis. Several drug-related subreddits on Reddit were selected to search for xylazine-related posts. Initial subreddits were selected based on study group consensus of subreddit relevance and prior experience using Reddit to evaluate patterns in drug use. We used a thematic content analysis approach to classify posts into different codes. The coding process was a multi-label classification and each post could be assigned one or many codes. An anonymous English-language survey was developed to include questions about demographics, patterns of xylazine use, and experiences from using xylazine. All respondents gave digital informed consent prior to beginning the survey. Survey questions did not include any personally identifiable information or contact information in order to preserve the respondents' anonymity. The survey was 18 questions and there was no financial incentive Supplement S1. The survey was posted on seven drug-related subreddits from March to August by a member of our research team A. The subreddits where the survey was posted were identified through the qualitative analysis as having the highest number of posts about xylazine. Additional drug related subreddits with large numbers of subscribers were also identified as potential locations to post the survey. From this set, only subreddits where the moderators allowed the posting of the survey were included. The survey link was posted after the qualitative data had been gathered so as to not influence the content of posts being analyzed in the qualitative analysis. The anonymous survey results were exported to Microsoft Excel for analysis. Possible misspellings of xylazine were also generated via a validated NLP tool prior to conducting the search. Fourteen posts were excluded for 1 not mentioning xylazine in the post or 2 discussing a veterinary use of xylazine. Major themes that were identified included discussion of other drugs used with xylazine, method of using xylazine, and geography of xylazine use. Additionally, posts that discussed dependence or addiction to xylazine and other drugs were identified to further understand patterns of xylazine use as well as to explore the impact xylazine might have on medications for opioid use disorder MOUDs. Table 1 includes major themes with example quotes and counts of times major themes appeared. There were a total of 61 participants who completed the survey. Survey participant demographics are outlined in Table 2. The median age range reported by participants was years old. Of the 25 responses that were included from a state in the Northeast, 12 responses were specifically from Pennsylvania. Included 2 responses from the United Kingdom, 2 responses from Canada, 1 response from Sweden, and 1 response from Ecuador. Participants were asked about drug use history including frequency of use, routes of exposure, and concurrent drug use with xylazine Table 3. Participants reported adverse effects from using xylazine Table 4. The participants emphasized many of these adverse effects of xylazine in a free response prompt to share any specifics about xylazine. Some participants emphasized the severity of the wounds they experienced as:. Chest pains. Stretching feeling. This novel study adds to the literature about xylazine, an emerging psychoactive substance that is increasingly being detected in the illicit drug supply. This study found that most of the participants did not seek out xylazine, participants were primarily from the northeastern United States, and many participants reported increased wounds and worsened withdrawal symptoms. First, we found that most participants were not intentionally seeking out xylazine in the drugs they use daily. Other studies of xylazine have found it to be an undesired adulterant in the drug supply. This behavior may be motivated by the desire to avoid withdrawal from xylazine, which several participants reported as well. The biologic plausibility of xylazine use contributing to increased skin wounds has not been elucidated, however, this study adds to other studies that have reported this finding. Second, this study corroborates the findings from other studies that xylazine use is concentrated in the northeastern United States. This is similar to the findings of Friedman et al. Given the high rates of concurrent fentanyl use, it would be expected that xylazine use matches the demographics of people who use fentanyl. More recent data shows that fentanyl overdose death rates are more rapidly increasing among non-Hispanic African American males. Third, we found the PWUD reported worse withdrawal symptoms from other drugs after they had started using xylazine. Although we do not know the exact relationship between xylazine use and withdrawal from other drugs, this self-reported experience is concerning. Opioid Use Disorder has high morbidity and mortality, and ongoing withdrawal symptoms can lead to discontinuation of or further challenges to initiation of MOUDs. Fourth this study demonstrates the potential opportunity to recruit participants from Reddit to participate in biomedical studies. Although there are a growing number of studies that use NLP to look at existing posts on Reddit to answer research questions, there are few studies that use Reddit for surveys or as a recruitment tool. Although this study did not directly answer the question of how harm from xylazine could be reduced, it highlights several issues facing PWUDs who are exposed to xylazine. More research is needed to understand the concomitant use of fentanyl and xylazine and the relationship between xylazine use and skin wounds. There are several limitations to this study. As discussed above, the demographics of people who use Reddit may not be representative of the general population or the population of PWUDs, limiting the generalizability of findings in our study to all PWUDs. Thus ongoing research into how xylazine is being used across time and geographics is needed to address the emerging needs of PWUDs who are exposed to xylazine. Among people on Reddit, xylazine appears to be an unwanted adulterant. PWUD may be experiencing more negative side effects such as prolonged sedation, increased skin wounds, and worsening withdrawal from other substances. This appeared to be more common problem in the Northeast and among people who self-report opioid use. Reddit shows promise as an avenue to disseminate surveys and possibly even recruit participants to studies that wish to explore sensitive topics. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. This is a preprint. It has not yet been peer reviewed by a journal. Find articles by Anthony Spadaro. Find articles by Sahithi Lakamana. Find articles by Abeed Sarker. Find articles by Rachel Wightman. Find articles by Jennifer S Love. Find articles by Jeanmarie Perrone. PMC Copyright notice. Updated version available: A peer-reviewed version of this article, ' Self-reported xylazine experiences: A mixed methods study of Reddit subscribers ', has been published in Journal of addiction medicine. The complete version history of this preprint is available at medRxiv. I was so upset if my fetty wasn't cut with it. Thinking ahh I got the methadone to fall back on an I'll be fine.. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Posts that discussed xylazine use with other specific drugs. Posts that described a positive or negative experience about using xylazine. Posts that discuss dependence, addiction, or withdrawal to xylazine and other substances. Have you experienced withdrawal from xylazine? How has withdrawing from other drugs changed since you started using xylazine?

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